Sleep apnea syndrome (SAS)

Description of the disease

It is the respiratory pauses that occur during sleep, lasting longer than 10s and recurring more than 7-10 times per hour. When this syndrome occurs, there are no respiratory system diseases. Sleep apnea is diagnosed in 10% of the population, most commonly in men over 50 years old, and occurs 8 times less frequently in women.

According to the origin, SAS is divided into 3 types:  

a) obstructive due to narrowed airways. This is the most common type of apnea. Airways can narrow due to congenital anomalies, traumas, inflammatory changes in the airways, and obesity. When the airways are narrowed, a person snores, but snoring does not necessarily mean there will be apnea. It can develop after prolonged snoring due to damage to the airway tissues. Respiratory pauses last up to 1 minute.

b) central – due to damage to the respiratory center in the brain. Breathing stops during sleep for 10-25 seconds. This type of apnea is often the cause of sudden infant death syndrome. Obesity can also contribute to this apnea.

c) Mixed – temporary cessation of breathing during sleep due to both of the first mentioned causes. Lasts up to 2 minutes.

Diagnosis

Often starts with snoring during sleep, disturbed breathing at night, morning headaches, and daytime sleepiness. Patients feel that their memory and attention are weakened, leading to decreased performance, falling asleep while reading or driving. They experience decreased libido, frequent nocturnal urination, excessive night sweats, and waking up in panic at night.

Objective sleep respiratory testing and electroencephalogram are important for diagnosis. Also, examination by an otolaryngologist and dentist is crucial, as the origin of the disease can be influenced by nasal polyps, deviated septum, irregular positioning of the molars, and a small lower jaw.

Treatment

Positive airway pressure devices are used throughout sleep for those with uncorrected deviated septum. Surgical corrections are also performed to remove the cause of apnea. Weight loss always has a significant effect. Medication is not used.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology